Thursday, April 15, 2010

Why Can't My Child Pay Attention?

A common reason for attentional difficulties is sensory defensiveness. This means that the child experiences certain sensations that we would either find neutral, or would not even register, as unpleasant or threatening.

A defensive nervous system has a hard time adapting to novelty and filtering out extraneous information. What this means: when you put your shirt on in the morning, you feel it going on, maybe briefly noticing the texture of the silk or wool or cotton, and then your skin adapts to it and the sensation of your shirt on your skin no longer registers in your conscious awareness. Your nervous system is filtering it out, since it is not relevant. This way, your conscious awareness can focus on other things.

A defensive system, on the other hand, would constantly be sending messages: This shirt is itchy! This shirt is bugging me! The label is scratching my neck! The seams on my socks are rubbing my toes and causing huge, oozing, bloody blisters, I just know it! My jeans are too stiff! My underwear is too tight! The label on my panties is poking a hole in my back! My pencil is bugging my thumb! The teacher's voice is drilling a hole in my head! It's too noisy in this cafeteria, I can't eat! The food looks and smells disgusting! Oh, no, someone is getting too close to me, what if he wants to hit me, I'd better do something quick! Oh, no, the teacher is going to use chalk on the blackboard, what if it squeaks! The smell of finger paints is making me sick! The gym teacher is talking, but I can't figure out what she's saying over the rest of the shouting, and it's too loud in here anyway! What's that coming toward me! I hate playing basketball, it's dangerous!

It's challenging to pay attention and participate when your nervous system is constantly bombarding you with messages like that. I liken it to having a fever, when lights are too bright, everything feels scratchy, voices and sounds are too loud, and all you want to do is go home and put a blanket over your head. For a sensory defensive child, every day feels like that. When the sensory information that is bombarding them becomes too much to handle, one way of coping is to just tune out and shut down. If the child's teacher says that the child is often staring out the window, doesn't seem to understand what is being said, can't follow directions, wants to play by herself, hides in the corner, and rarely joins in during groups or at the playground, preferring instead to sit on the sidelines, this may be what is happening.

If a child is a chronic mouth breather or a shallow breather, this can also cause problems with attention and learning. A brain that is starved for oxygen is not one that is primed to pay focused attention. When we are anxious, our breathing tends to become shallow, and when we breathe shallowly, we tend to become anxious. If you don't believe me, try some shallow panting for a minute and notice the chemical reaction that results. An anxious child in chronic low level fight or flight mode is not in an optimal state for learning.

Children who have low trunk tone, are chronic slumpers, or who lay their bodies on their desks and have a hard time sitting up or sitting still, can have attentional problems because they don't have enough strength or energy to sit in one place for a long time. They are using up the energy they should be focusing on the lesson just to stay upright.

Low trunk tone also affects the fine motor coordination of the eyes, because they don't have a stable base of support from which to function. If you are struggling to see what you are doing, it is very difficult to sustain attention to close work.

Imbalances in neurotransmitters and brain chemistry can definitely affect a child's ability to focus. So can structural problems in the body.

Other factors that can affect a child's ability to attend include diet, food sensitivities, sleep patterns, elimination habits, and allergies.

In a future post I'll talk about referrals I make to specialists who treat these issues.

3 comments:

Your description of "sensory defensiveness" reminds me of a time years ago when I used to do music activities with pre-schoolers. I would play guitar or mandolin and lead sing-alongs. I remember one boy in the 3-yr old class who always covered his ears and whined, "It's too loud." There was another boy who refused to sing because he later told us, "If I sing, I can't hear the song." (I thought his point was excellent; I myself usually prefer to listen rather than sing along, and I HATE it (in adult contexts) when audiences start clapping along with the rhythm of the song. But of course, in an activities class, the teacher is expected to entice the kids to participate. Curriculum vs aesthetics!)

As an adult, I have diagnosed as a "super-taster." This is generally considered a pretty good thing, even a gift, especially for a chef, but I recall as a child having had sensations very similar to those you describe, when smalls and tastes were constantly assaulting me from every corner. Thanks for a useful sensitive post.

About Me

I'm a pediatric occupational therapist specializing in sensory integration and school based issues, particularly handwriting. I also teach the Alexander Technique and am a practitioner of Positional Release and other forms of manual therapy. I live and practice in Manhattan.